A digital health kiosk is acceptable, usable, and improves decisions about high-risk over-the-counter medications when used by older adults: Results of formative user testing

Background

Older adults' use of anticholinergic medications is associated with increased risks. Despite widespread use of over-the-counter (OTC) anticholinergics, interventions to decrease older adults' anticholinergic use have focused mainly on deprescribing of prescription anticholinergics, with little attention to OTC anticholinergics. Consumer-facing health technology in community pharmacy settings may decrease older adults' OTC anticholinergic use.

Objective(s)

Evaluate older adults' attitudes and behaviors toward a digital health intervention for increasing OTC medication safety.

Methods

In 3 groups, older adult participants (total N = 13) were individually shown and used an information kiosk prototype during controlled usability testing. Each participant completed 3 OTC medication decision scenarios in randomized order; their decisions were recorded and deemed unsafe if an anticholinergic product was selected. Scaled-response surveys assessed perceptions of kiosk usability and acceptability.

Results

Among participants given subsequent prompting after the first group of testers (n = 9), 100% used the kiosk to aid their OTC medication decisions. Only 5 participants (38%) used the kiosk without prompting. Initial decisions had a 37% rate of unsafe medications, whereas 4% of final decisions were unsafe, a change attributable to kiosk use. Self-reported usability and acceptability scores were high, with 85% reporting they would, given the opportunity, use the kiosk at least “a moderate amount.”

Conclusion

A kiosk designed to reduce use of OTC anticholinergic medications is usable and feasible for older adults but may not initially be used. When used, kiosks and related digital solutions can lead to safer OTC medication decisions. This study is limited by its small sample size and controlled, lab-based setting. Further work is needed to examine initial attraction and sustained user engagement in real-world OTC decision scenarios.